Chairman’s Message

Thank you for your interest in the Department of Surgery here at Mercer University School of Medicine and the Medical Center of Central Georgia. In recent years we have made great progress in both resident education and patient care. Some highlights are noteworthy.

American Board of Surgery examinations.

The past two years’ graduating chief residents all passed their certifying examinations (CE, written board exams) of the American Board of Surgery (ABS), giving us a first taker CE pass rate for the five year interval ending 2011 of 86%. The first taker pass rate for the oral exam is now also 86%, and for both exams the rate is 75%. For comparison, the five year interval ending 2006, five years ago, the rates were 79%, 73%, and 57%, respectively. The first-taker pass rate for the ABS examinations is one of the benchmarks the Accreditation Council for Graduate Medical Education (ACGME) and the Residency Review Committee for Surgery uses to measure the effectiveness of resident training. Professor and emeritus Dean and Chair Martin Dalton serves as Associate Program Director for resident education and guides the didactic curriculum for the Residency.

Resident achievements.

Chief residents from the program have largely pursued post graduate fellowship training. Over the past three years 8 of the 10 graduating chief residents have won their first choices in training positions in both university-and hospital-based programs: pediatric surgery (Arkansas Children’s Hospital), surgical critical care (MCCG and Vanderbilt University), minimally invasive surgery (Baton Rouge and Kansas City), and plastics and hand surgery (Medical University of South Carolina and University of Virginia). Two entered general practices in Jackson, Tenn., and Greenville, S.C.

Residents received state and regional recognition over the past year. Eric Long, PGY-5, won the best basic science paper award at the state resident paper competition of the Committee on Trauma American College of Surgeons (COT-ACS) this year in August, the third straight year he has won the award. Previously he has placed in regional competitions and presented his work at the national COT-ACS meeting. Jacob Moremen, PGY4, and Jason Chapman, PGY5, have won the Looking to the Future Scholarship of the Society of Thoracic Surgeons to attend the national STS meeting in January, Dr Moremen in 2011 and Dr Chapman in 2010. Brad Dennis, ’11, received honorable mention in the Eastern Association for the Surgery in Trauma essay competition in January.

Clinical and basic research.

Residents and staff had 20 peer-reviewed publications, 7 extramural presentations, and 10 invited lectures over the 2010-2011 academic year. Some were noteworthy contributions. Dr Zhongbao (J.B.) Wang continues to lead a productive basic science laboratory investigating the effects and underlying biochemical mechanisms of inflammation on endothelial function. Dr Long’s research awards are noted above. Trey Keadle, PGY3, presented his work with Dr Wang at the national Clinical Congress of the American College of Surgeons in 2010. Dr Moremen and Tracy Nolan, PGY1, have an important clinical article in press in the Journal of Trauma that documents improved cardiovascular stability in spinal cord injured patients with the early use of cardiac pacemakers, work that he conducted with Drs Leon Sykes, Benjie Christie, and Dennis Ashley of the Department and Trauma and Surgical Critical Care services. Dr Dennis will be presenting his work at the Eastern Association for the Surgery of Trauma meeting this fall on the value of a checklist to improve communication with families of trauma patients. Vincent Scoglietti, PGY5, will be presenting his work on improvement of patient care handoffs at the national ACS meeting this fall.

Mercer medical students in general surgery.

Over the past two years 16 of the 120 Mercer graduates (13%) went on to residencies in general surgery. Some have stayed to train with us at MCCG. Importantly several have won positions at residency programs in general surgery at other programs, including the Atlanta Medical Center, East Virginia Medical School (Norfolk), Lackland (Tex.) AFB, Greenville (S.C.) Hospital system, Memorial University Medical Center in Savannah, Ohio State University, University of Nebraska, University of Tennessee in Chattanooga, University of Virginia, Virginia Commonwealth University, and Wake Forest University.

Recently two Mercer medical students received national recognition. Katie Wells, ’11, published an article in Surgery titled, “Social media in medical school education.’ Surgery is one of the leading journals in the field. Lindsey Karavites, ’12, won a national scholarship to attend the national meeting of the American Association of Women Surgeons in September.

ACGME accreditation.

In December 2010 we received word from the ACGME and the Residency Review Committee in Surgery that we won a five-year accreditation. The fellowship in surgical critical care, led by Dr Ashley, had its site visit in May 2011. Preparation for accreditation review and site visits requires not only months of administrative work and documents, but doing all the things over the years that make resident education meaningful and important. We’re very proud of the recognition that full accreditation brings.

Rural surgery.

In March 2010 residents began to have a one-month elective rotation in rural surgery as a PGY2 in Cordele, Ga., with clinical faculty at Taylor Regional Hospital 90 miles south of Macon. Residents experience rural practice with experienced surgeons, and routinely come away with more than 50 operations and endoscopies. Clinical faculty William Pannell, Michael Thompson, and Vincent Culpepper provide this valuable clinical experience. The positive learning experiences have led us to expand elective sites with other rural practices in Americus and Donalsonville, and expand elective opportunities in rural surgery to senior PGY4 residents.

Simulation center.

The Center for Innovative Learning, a $1.2 million, 2,800 square foot simulation center and classrooms, opened January 2011. The center has virtual reality training systems for laparoscopic surgery, simulated adult, infant, and newborn patients controlled by remote computers, and an area where teams of providers can practice clinical skills in a simulated O.R., I.C.U., and E.R. setting. A conference room allows play-back of mock scenarios so that learners can observe their actions and participate in valuable feedback sessions. “Box trainers” permit individual practice of routine procedures such as basic surgical skills, peripheral and central intravenous line placements, and the use of new devices and equipment. The Center was the result of years of planning led by Marcia Hutchinson, Chief Academic Officer for MCCG. William (“Kim”) Thompson is medical director of the Center.

Additions to the fulltime faculty.

David Feliciano, one of the foremost experts in American surgery and the field of trauma and surgical critical care, joined the faculty in August as Professor and Associate Director of Surgical Critical Care at MCCG. He will add immeasurably to patient care and education at both resident and medical school levels. Robert Parel, a general surgeon with significant experience in minimally invasive surgery, already is a resident favorite. D. Benjamin Christie, a specialist in surgical critical care, and Joshua Glenn, pediatric surgeon, just completed their first years on the full time staff. All are dedicated to resident and medical student education, and providing first rate care to our patients.

Vascular surgery.

A flagship service, the surgeons of the Macon Cardiovascular Institute merged with the employed physicians group at MCCG last year. The result was a significant strengthening of the operative experience and education in vascular surgery for residents, with regular pre-operative angiography management conferences, morbidity and mortality conferences, and continuing medical education symposia. Led by Maurice Solis, the group includes Alan Stevick, Juan Ayerdi and Billy Mix. MCCG was recently recognized by a state business journal as having the leading vascular surgery service line in the state, in large part due to the MCVI group.

Pediatric surgery.

With new pediatric surgeon Glenn joining established surgeon Sam Shaker, a major resource for advanced pediatric surgery developed in Macon for the central and South Georgia regions. Volume of cases approached 2,000 in the year ending September 2011, approaching those of major children’s hospitals in Atlanta and Birmingham. Andrew Bozeman, chief resident class of 2011, and Eric Long, 2012, both received word of their positions in clinical pediatric surgery and pediatric surgical research, respectively, in spring 2011. We are proud of them.

Trauma and Surgical Critical Care Fellowship.

The fellowship training program in surgical critical care at MCCG began its fourth year with two trainees, Amy Christie and Mustafa Ahmed. Dr Ashley continues to be the leader of trauma care in the state as chair of the state trauma commission. Macon and MCCG is a test site for the state for a network of trauma communications that monitors critical care bed and surgical specialist availability in medical centers in a region, allowing injured patients to be directed to hospitals with ready resources and personnel. MCCG also holds telemedicine consultations for injured patients arriving in non-trauma center area hospitals. A major objective for the upcoming year is to organize fulltime coverage of surgical critical care units by board certified specialists in surgical critical care.

Continuing education programs in surgery.

The Department has organized its grand rounds and visiting professor programs to conform to requirements and standards of the Accreditation Council for Continuing Medical Education. In conjunction with hospital quality improvement projects the Department has organized year long programs that combine visiting professors, journal clubs, hospital quality data, and individual surgeons’ self-reported data. Improvements in care and outcomes will monitor the efficacy of CME programs, with participants reviewing data and deciding on interventions and future projects. Involvement in the CME project will satisfy American Board of Surgery maintenance of certification requirements. In September the inaugural unit on surgical site infections will be completed and a new program on venous thromboembolism will begin. Donald Fry, noted expert on surgical site infections, was our visiting professor on the subject, and Lazar Greenfield, whose contributions to the subject of VTE are world famous, will be the featured speaker in September for the next year’s program.

National Surgical Quality Improvement Program (NSQIP).

MCCG will join NSQIP in fall 2011. NSQIP is the major quality program of the ACS, with a record of improvement in surgical outcomes since its inception with the Veterans’ Administration hospitals in the early 1990s. Dr Thompson will be the designated surgical champion for the program.

Leadership in hospital programs.

Department surgeons occupy leadership positions and have been involved in process improvement projects at MCCG. Macram Ayoub, Professor and Vice Chair, is member of the hospital Medical Executive Committee, the body charged with medical policy-making. Drs Ashley and Glenn are members of the Surgical Services Executive Committee, which sets policy for the operating room. Dr Thompson leads a multi-departmental committee addressing quality issues. Dr Nakayama organized a pediatric surgical service line group to improve pediatric surgical quality. Improvements in care were reported in an article published in the AORN Journal, the peer-reviewed publication of the Association of Operating Room Nurses. Dr. Glenn continues providing leadership for the pediatric surgical service line, focusing on equipment and scheduling issues

We continue to make improvements to what is already an exciting place to work, train, and practice surgery. We appreciate your interest in our program, and would love to talk about your being one of our team.

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